Provider Demographics
NPI:1407984107
Name:BURRIS LABORATORY SCHOOL
Entity Type:Organization
Organization Name:BURRIS LABORATORY SCHOOL
Other - Org Name:BALL STATE UNIVERSITY
Other - Org Type:Other Name
Authorized Official - Title/Position:SCHOOL PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-285-1131
Mailing Address - Street 1:2000 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47306-1062
Mailing Address - Country:US
Mailing Address - Phone:765-285-1131
Mailing Address - Fax:765-285-8620
Practice Address - Street 1:2000 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-1062
Practice Address - Country:US
Practice Address - Phone:765-285-1131
Practice Address - Fax:765-285-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)